HAVE THE BENEFITS OF ELECTRONIC HEALTH RECORDS BEEN OVERSTATED?

March 13, 2009

The flagship proposal presented by President Obama at last week's health care summit was the national adoption of electronic health records, but EHRs are an overly simplistic and unsubstantiated part of the solution to problems with the U.S. health care system, say Drs. Jerome Groopman and Pamela Hartzband, staff members at Beth Israel Deaconess Medical Center and faculty members of Harvard Medical School.

Obama based his proposal on a 2005 RAND study on EHRs, for which there was no compelling evidence at the time to support the study's theoretical claims.

The cost savings from avoiding medication errors are relatively small, amounting at most to a few billion dollars yearly, as the RAND consultants admit.

Other potential cost savings are far from certain; for example, the impact of medication errors on malpractice costs is likely to be minimal, since the vast majority of lawsuits arise not from technical mistakes like incorrect prescriptions but from diagnostic errors and there is no evidence that EHRs reduce those errors.

They continue that much of the growth in health care costs is caused by the proliferation of costly new technology and treatments, as well as by administrative overhead related to insurance billing and payments, uninsured patients using emergency departments and end-of-life care. The president and his health care team have yet to address these difficult and pressing issues, they say.

Our culture adores technology, so it is not surprising that the electronic medical record has been touted as the first important step in curing the ills of our health care system, they say. However, they conclude, the country instead needs Obama to apply real scientific rigor to fix our health care system rather than rely on elegant exercises in wishful thinking.